Biomedical research institutions in Oregon are outstanding, and are prepared for a major expansion in clinical/translational investigation. We propose to form the Oregon Clinical and Translational Science Institute (OCTSI). The OCTSI will fundamentally change biomedical research to create a vibrant academic home for clinical/translational investigation. It will leverage existing strengths and remove barriers to the pace and growth of research. At the heart of the OCTSI is a robust partnership between Oregon Health &Science University (OHSU) and Kaiser Permanente's Center for Health Research (KPCHR) that brings together a strong biomedical research university and an innovative practice-based research center associated with a large patient population. The collaboration provides unique opportunities for expansion across the spectrum of human investigation, and sets the stage for major advances in human health. Transformation of clinical and translational research in Oregon is enhanced by: Robust institutional support for the OCTSI, manifest by significant administrative change as well as the commitment of substantial financial and space resources; Academic faculties at OHSU and KPCHR that fully support the OCTSI initiative and the development of a strong, multidisciplinary OCTSI leadership team; Merging of resources to form a coordinated infrastructure for clinical/translational research;Strong ties to the community and the involvement of the region in the human research agenda. We have identified three major goals for the OCTSI, and propose far-reaching, explicit and feasible approaches to achieve them. We will 1) Create an academic home (the OCTSI) specifically devoted to the discipline of clinical/translational research, 2) Nurture a new cadre of highly-trained, interdisciplinary investigators through a strong, diverse educational curriculum, 3) Create a "Research Commons" - a coordinated infrastructure of core research tools that greatly expands research opportunities and provides a unified, effective means for their access. There are particular opportunities to accelerate progress in pediatric and child health, community based research, and human genetics.